Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nutr 337 > 7- micronutrient requirements during pregnancy > Flashcards

7- micronutrient requirements during pregnancy Flashcards

1
Q

calcium

A

no additional Ca req during pregnancy ( no change in maternal one mass during pregnancy) - intestine increases absorption during this time ( increase in active vitamin D - BUT this is not what causes the increase in intestinal absorption)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

around _____ g of Ca are transferred to the fetus throughout pregnancy ?

A

25-30 g - majority of transfer sin the last trimester ( makes sense bc max period of skeletal growth )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

% increase in calcium absorption

A

10% - may be due to an increase in calcium hormones – not vitamin D increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how did they find out about increase in calcium absorption

A

due to the fact that, if the women does not et enough calcium in the diet, she will not lose maternal bone reserves, she absorbed more calcium - more efficiently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

where is calcium transfer coming from ?

A

not from mothers bones, don’t want to sacrifice her bone health– probably survival mechanism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

blood concentration of 1,25 (OH)2D ?

A

increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

calcium RDA during pregnancy

A

does not increase and stays at 1,00 mg/d = 19-50, or 1,300mg/d if under 18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

phosphorus?

A

no additional intake needed bc 10% increase in absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

phosphorus EAR and RDA

A

580 mg/d and 700 mg/d for both men and women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

phosphorus if under 18 yrs?

A

goes up from 700 to 1250 mg/d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

serum Mg does _____ during pregnancy

A

down - thought to be bc of hemodilution ( bc of similarity with serum potassium )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

magnesium during pregnancy

A

it increases ( EAR an additional 35mg/d), this is bc there is no data on an increase in intestinal absorption therefore, with the extra weight gain the body is assumed to need more magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

RDA for mg during pregnancy ( 14-18, 18-30, 30+)

A 
14-18 = 400 mg/d
18-30= 350 mg/d
30+ = 360 mg/d
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

EAR of magnesium for pregnant women

A

additional 35 mg/d ( based on weight gain associated with pregnancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

iron during pregnancy

A

increases in the second and third trimester but it decreases in the first trimester ( lower than non-pregnent women bc no menstraul losses -6.4 mg/d ), but absorbance also increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

total usage of iron during preg

A

1,070 mg ( 250 basal loses, 320 mg for fetal and placenta deposition and 500 mg for increase in hemoglobin mass)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

trimester increases in iron

A

6.4 mg/d at 18% absorbance, 2nd trimester 18.8 at 25% absorption and 3rd trimester is 22.4 mg/d at 25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

severe anemia associated with?

A

perinatal material mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

moderate anemia associated with

A

twice the risk of maternal death - heart failure, hemorrhage and infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

large epidemiological studies show what is associated with anemia

A

premature delivery, LBW and increase in perinatal infant mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

high HB concentration at eh time of delivery is associated with

A

adverse pregnancy outcomes ( U -shaped curve with low and high levels- need a balance) increased risk at greater than 130 g/L or less than 90 g/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hb range present women want to aim for

A

90 g/L and 130 g/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

why are there risks with high Hb levels?

A

may reflect a decrease in plasma levels–> maternal HPT and preeclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what does iron supplement assume during pregnancy

A

that there were inadequate stores pre -pregnency –> if they were normal stores, supplement may not be nessasay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

iron RDA for pregnancy

A

27 mg/d for all age groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is RDA based on

A

3rd trimester, build iron stores during the first trimester ( bc assuming inadequate stores) and using an upper limit of 25% absorbance, CV of 10% for RDA= 120% of EAR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

AI for potassium

A

no change –> 3.4 males and 2.6 females this was recently decreased from 4.7 g/d bc of lack of evidence) - was higher before ( to do with more K increases Na excretion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

sodium in pregnancy

should women with preeclampsia or hypertension decrease salt intake?

A

extra 2.1 -2.3 g over the 9 months –> Na in order to maintain plasma volume,
0.07g/d additional per day –> o bc it is so minimal the AI does not change –> still 1.5 g/d

should women with preeclampsia decrease salt intake? no there is no effects- there are other factors involved- mostly overweight stays- so they should not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Thiamine RDA

A

requirement increase by 30% –> 1.4 mg/d from 1.1 mg/d ( normal women) growth (20%) and (10%) for increase in energy utilization- thiamin functions as a coenzyme in the metabolism of CHO and BCAA(RBC transkelotase, thiamin pyrophosphate -TPP)

30
Q

Riboflavin RDA

A

up from 1.1 mg/d to 1.4 mg/d (same as thiamine) –> additional 0.3 mg/d is to do with increased growth in maternal and fetal compartment san dnincreas tin energy ( less urinary excretion of riboflavin and frequent appearance of clinical signs in women with low intake)

31
Q

Niacin RDA

A

increase from 14mg/d NE to 18mg/d, due to estimate that increased energy and growth would need more niacin however no direct intake

32
Q

vitamin B6 (pyridoxine) RDA

A

increases to 1.9 mg/d, bc significant fetus uptake of B6 (especially in the second half of gestation) but we do not store B6 efficiently so unlikely that excess in early gestation would do anything, need an extra 0.6 mg/d to meet needs

33
Q

fetus and placenta accumulate how much B6 during the entire pregnancy

A

25 mg( about 0.1 mg/d)

34
Q

in order to maintain pyridoxal phosphate ( which is the common marker ) how many mg B6 would need to be supplemented? why is this not the current RDA?

A

1mg/d in first semester and 4-0 mg/d the 2nd and 3rd.

however the RDA is 1.9mg/d, this is bc even though this marker decreases there is no efficiency that there is an issue with this- this may be a normal physiological change
( more than just hemodilution)

  • however, 25mg over the course of the pregnency is needed to accumulate in the placenta and the fetus which is about 0.1 mg/d–> we over shoot this and make the RDA 1.9 g/d ( bc of metabolic needs of mother, and additional average pregnancy need and -75% bioavailability)
35
Q

why does folate req increase so dramatically ?

A

increase in single carbon transfer reactions –> cell division and nucleotide synthesis –> uterine enlargement, placenta dev, expansion of maternal erythrocyte number and fetal growth

36
Q

what happens with inadequate folate status?

A

megaloblastic anemia, marrow changes low folate concentration ad maternal serum and RBC

37
Q

what is the primary indicator of adequacy for folate

A

erythrocyte folate maintenance ( reflects storage in tissues)

38
Q

folate EAR and RDA during pregnancy

A 
EAR= 520 ug/d ( derived from EAR for non pregnancy women ( 320 ug/d) + 200 ug/d--> found that low intake + 100 g supplement was inaqequate) 
RDA = 600 ug/d and women that are capable of becoming pregnant need to be taking 400 ug/d from fortified foods, sups or both + CONSUMING FOOD FOLATE from a varied diet to prevent NTD
39
Q

all women should be taking?

A

400 ug/d supplement or fortified food

- this is unto of food folate ( basically saying food folate doesn’t count )

40
Q

why does B12 absorption increase during pregnency

A

increased number of intrinsic factor B12 receptor

41
Q

B12 (cobalamin) EAR and RDA

A

EAR increase by 0.2 ug/d, RDA 2.6 ug/d

42
Q

are maternal liver stores of B12 important for the fetus

A

not really, only the newly absorbed B12 gets transported across the placenta ( the current B12 intake during pregnancy and the absorption are more important than pre-stores)

43
Q

biotin during pregnancy

A

no additional requirement

  • recent studies are conflicting- showing either a high or low plasma concentration
  • increase in biotin metabolite in half population and then a decrease in urinary excretion in half population
  • unknot if normal physiological change or if indicative of low intake
44
Q

factors affecting biotin requirement

A
  • consuming raw egg whites increase need ( avidin)
  • biotinidase def decreased the function of the enzyme- increases need
  • anticonvulsants induce biotin catabolism, increasing need
45
Q

choline AI? increase?

A

AI= 450 mg/day ( increase of 25mg/day)

- requirement increases bc fetus needs a lot and could deplete mothers status

46
Q

choline def in preg leads to

A

increase in homocysteine -> birth defects ( and 90% of Americans are NOT ingesting enough choline- may be done through eggs)

47
Q

pantothenic acid and preg

A

no info that usual intake is inadequate, AI = 6mg/d

48
Q

vit C EAR? increase? RDA

A

maternal vit C concentration goes down - hemodilution and active transfer to the fetus so additional vit C is needed

EAR= increase 10mg/d
RDA= 85 mg/d
49
Q

subpopulations may need more vit C such as

A

smokers, heavy alcohol use, regular aspirin use

greater than20 cigs a day need twice as much vitamin C–> 35 more mg

50
Q

vitamin A requirement increases?

A

about 50 ug/d during last trimester ( most of accumulation happens in the last 90 days)

51
Q

vitamin A EAR

A

50 ug/d + EAR for non prep women (530ug/d)

52
Q

Vitamin A RDA

A

770 ug/d RAE

53
Q

UL of vit A is based on what?

A

teratogenicity, whereas in non pregnancy it is based on liver abnormalitites

54
Q

Vitamin D

A

small quantities transferred to the fetus –> no additional need during pregnancy

55
Q

vitamin E

A

no additional intake needed–> but there have been causes of vitamin E deficiency in premature newborns, however o data that supplement vit E would have prevented this

56
Q

Vitamin K

A

no additional intake needed during pregnancy –> stays at 90 ug/d (120ug/d men )

57
Q

folate to the cord blood is

A

active transport

58
Q

folate biomarker (most accurate)

A

RBC folate bc reflects tissue stores

59
Q

synthetic form of 100 ug folate ( equal to 200 ug of dietary folate form ) caused?

A

found to be insufficient so add this base to the non pregnent EAR ( 320 ug/d) = 520 ug/d

to ensure all women get covered, assume that all women going into pregnancy are low folate

60
Q

synthetic form of B12

A

is bioavailable boy itself, doesn’t need intrinsic factor

61
Q

serum (B12) levels _____ in first semester

A

decrease

- mother taking up more

62
Q

if mother is on a B12 deficient diet can the fetus use maternal liver stores of B12 ?

A

can last up to 2-3 years before signs of anemia, however for the fetus- these stores are less bioavailable ( issue with fetal uptake) fetus only wants the newly absorbed B12

63
Q

Choline

A

brain development - animal studies with increased spatial memory

  • -> offspring had faster processing ( with higher supplementation of choline)
  • -> may be higher supplest need - choline acts as a NT
  • involved in the methionine metabolism
64
Q

choline in methane metabolism

A

choline –> cofactor betaine– betaine is cofactor for homocysteine to methionine
( insufficient phosphatidylcholine leads to fatty liver)

  • dietary studies have linked low choline to NTD bc of the homocysteine to methionine
65
Q

sources of choline

A

fish, eggs, animal protein, cauliflower, Brussel spouts

66
Q

hypo-methylation linked to

A

deficient B12, folate and choline

leads to increased cortisol at placenta, epigenetic

67
Q

high folate acid supplementation

A

increased risk of colon cancer

- hyper- methylation
methylate checkpoints

68
Q

2 main factors that amount for additional protein req

A

new tissue growth

maintain of

69
Q

teratogenic effects (malformations) with protein def? with iodine?

A

microcephaly , cretinism

70
Q

folate

A

population studies and confirm that a combination of ≈681 nmol (300 μg) synthetic folic acid/d from supplements, fortified food, or both plus ≈227 nmol (≈100 μg) dietary folate/d is sufficient to maintain normal folate status during pregnancy. Expressed as a DFE, the consistent finding across the numerous population studies and the controlled metabolic study is that 1362 nmol (600 μg) DFE/d is adequate to maintain normal folate status.

Nutr 337 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions